给创新开药方

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  美国的梅约诊所(Mayo Clinic)是世界最大的也是最佳的医院之一,医院创始人梅约父子从诊所的创建伊始就把“一切以病人的需要为先”作为诊所的工作守则。早在1800年左右,人们就尝试着将医生们聚集在一起工作,这样患者就可以在一个地方完成检查、诊断、治疗全部事宜,开创了综合性医院的先河。从此,创新也就成为了梅约诊所基因的一部分。
  梅约诊所最新的创新是让医生像创意师那样思考,从而把看病变得轻松有趣而不是痛苦和恐惧。
  梅约诊所的医生说,药物变了、患者变了、治疗技术也变了,但是整个看病过程却和100多年前没有什么不同,梅约要做的就是将应用在科学创新上的方法同样使用在患者看病创新上。
  排队候诊往往是带着病痛来看病的患者最不愿做的事,梅约的创新就从改变这点开始。现在梅约诊所的候诊室里设白纸、没接电源的笔记本电脑和按了也没有效果的触摸式电子屏幕,工作人员利用隐藏在各个角落的摄象机观察记录患者的反应和各种动作, 然后在此基础上进行思考和再设计。
  梅约诊所在医院内设计了高度透明的环境,患者可以通过玻璃墙看到护士和其他工作人员是怎样工作的,并在大厅开设简短的讲座,告诉患者关于医院和各部门功能的所有信息,从而打破了以往医院的神秘感,减轻了患者的疑虑。诊室里的空间布置也非常灵活弹性,根据不同病人的需要,可以自由移动墙壁、家具和办公设备。
  梅约的问题和其他设计师的困惑实际上没有什么不同,即在这个日益竞争的环境中,怎样实现差异化,怎样不断冒出新鲜的想法并用时尚的方式实现它,与此同时还能给消费者带来实际的利益。这对世界上最受尊敬的医院是如此,对所有企业恐怕也是如此。
  
  The first kiosk looked like a grade-school project or a prank. It didn't have a screen. Didn't even plug in. Patients stared at a piece of paper and tried to imagine the real thing, a terminal that would allow self-service check-in for a doctor's appointment. The next iteration was less primitive, a laptop with an apparent touch screen, except that it didn't work; someone sitting beside it, using a separate keyboard, typed in the system's response like a high-tech ventriloquist. The model after that had a responsive touch screen, but the functionality was sparse. No matter. The kiosk was getting there.
  And that was the idea: Put the earliest version, the rough sketch, in front of patients to see what they thought. Then use the feedback to tweak and retest. Then do the whole thing over again.
  The Mayo Clinic in Rochester, Minnesota, is no stranger to innovation. W.W. Mayo and his sons-still known here as Dr. Charlie and Dr. Will-founded their rural group practice in the late 1800s around a new concept at the time: integrated medical care, which involved various specialists working together in the same building, performing comprehensive evaluations, and administering coordinated treatment. Ever since, innovation has been a vital part of the clinic's DNA, traditionally in the research lab.
  But the approach with the kiosk-rolling out unfinished ideas to patients-is something new. Last summer, Mayo opened SPARC, a clinical innovation lab that operates like a design shop and that specializes in the "patient experience." Doctors, nurses, and other staff do what designers do: they interview, shadow, and observe customers (in this case, patients) to uncover their needs, brainstorm with abandon, and engage in rapid prototyping-hence, the paper kiosk.
  Despite its status as one of the best known and most respected medical facilities in the world, Mayo is wrestling with the same issues that designers routinely tackle: in an increasingly competitive field, how do you differentiate yourself? How do you generate fresh ideas and implement them in a timely fashion? And how do you make sure those ideas actually benefit customers?
  Mayo's program is "definitely unique, and it has enormous implications," says Dr. Samantha Collier, vice president of medical affairs at HealthGrades, which rates the quality of the nation's hospitals. "Medicine has long been embedded in tradition. But just because this is what we've done since the days of Marcus Welby doesn't mean it's still the best way. Mayo could find disruptive ways of practicing medicine better. This isn't just about customer service but about quality."
  SPARC is not simply a research lab or a medical clinic. It's both. Real patients see real doctors and, in doing so, participate in experiments (they're briefed and asked for permission). Instead of being shunted off-site, the program is based in the Mayo Building like any other clinic; it occupies a corridor that used to house urology. The acronym, which stands for "see, plan, act, refine, and communicate," is meant to remind participants of the design-oriented methodology so they'll continue to employ it when they return to their departments.
  The idea grew out of the realization that outpatient care is overdue for fresh ideas. "Medicine has changed, people have changed, technology has changed, but the exam room isn't so different than it was in the 1800s," says Dr. Michael Brennan, an associate chair in the department of medicine, where the program originated. Mayo wants its doctors to apply the same experimental approach to clinical innovation that they apply to scientific innovation.
  Ryan Armbruster, SPARC's director of operations and design, researched how other organizations, such as Procter & Gamble and Hewlett-Packard, foster innovation, and was struck by the prominent role of design. Dr. Alan Duncan, SPARC's medical director, had always thought of design as merely about aesthetics, but he quickly recognized the parallels to health care. "Look at how physicians generate a diagnosis," he says. "You do a history, listen, and think about all possibilities. It's purposefully broad to avoid locking into an early diagnosis, just as a designer wants to avoid locking into an early solution."
  The inclusion of actual patients is critical. Understanding user needs, after all, is a tenet of smart design, says Armbruster. There are three types of needs: those that are explicit and tacit and can be identified by surveying and interviewing people; those that can't be articulated but become apparent through observation; and latent needs, the hardest to root out. "The only way to identify them is to make something and have people experience it," Armbruster says.
  Dr. Victor Montori, an endocrinologist, brought doctors and patients to SPARC to experiment with a new way of discussing statins, drugs that lower high cholesterol. Too often, he says, patients get overwhelmed with information and let the doctor choose the treatment. Because they didn't decide for themselves, patients tend to abandon the therapy, which puts them back in the doctor's office.
  Montori tested a one-page guide that gives an individual's risk of a heart attack, shows how statins affect those odds, and outlines possible side effects. He's still reviewing the data, which suggests better adherence to medication, but he already knows that the personalized guide got patients' attention. "After the fifth or sixth prototype, we started seeing an emotional and physical response," Montori says. "They were moved." He knows this because SPARC's exam rooms are equipped with small cameras that provide rare glimpses into doctor-patient interactions. "We hear all the time about a clinician being empathetic," Montori says. "Now we're watching empathy at work. The eye contact. The listening. We see the whole dance."
  In fact, most everyone can see. With the help of office furniture maker Steelcase, Mayo created a highly transparent environment. The glass walls reveal SPARC's inner offices and show support staff working at the front desk; researchers reviewing project videos; and the SPARC team leading workshops in a central space that functions as an informal lounge and meeting room. SPARC removes the mystery found in a typical closed-off clinic.
  The space is also highly flexible. Much of the corridor, including the exam rooms, can be reconfigured to accommodate a variety of experiments. Walls, furniture, and computers can be moved like puzzle pieces. "People come expecting to see the finished product," says Armbruster. "But they experience the opposite. They see prototypes in different stages of evolution."
  Mayo's physicians both embrace design principles and integrate them with traditional medical research-in effect slipping the doctor's white coat over all-black designer duds. Doctors or managers propose a problem or a question they want to explore, and the SPARC staff assembles a cross-functional team, which gets a crash course on design methodology. By "the second hour, we were out with cameras, notepads, and tape recorders," says Becky Smith, a manager in patient education. Her team discovered that Mayo's main education center was confusing. It was intended for patients and family members to learn more about diagnoses or treatments. But because the space was open-no walls or doors-patients weren't sure if the computers were for them or the Mayo staff. When they did venture online, it was mainly to check email.
  After researching user needs on the Mayo campus, study groups typically reconvene in the SPARC lounge to share observations, ideally in the form of stories: how patients checked in, how they learned about treatment options, and so on. The goal is to explain how and why people behave the way that they do, to uncover the short cuts around a problem. Then the brainstorming begins. Whiteboard walls get papered with sticky notes and possible solutions. Finally, it's on to prototypes.
  Smith's patient education group generated a host of ideas: an enticing name for the area-"The Discover Center"; an entrance modeled after an artery of the heart; more interactive computer programs; anatomical models that encourage hands-on learning; and a snack bar devoted to learning about and making healthy food. Management approved one of the upgrades right away, removing a pillar to improve visibility. In the next two months, visits increased 15% over the same period a year earlier.
  The innovation program is still finding its feet, but Armbruster can tell it's having an impact. In one sense, it's subtle; he hears from workshop participants who are applying what they learned in SPARC in their day-to-day problem solving. But SPARC experiments are also beginning to have tangible effects on Mayo's patient experience. Take the long lines at check-in. The last thing people want when they're feeling sick or anxious is to stand around waiting. According to the SPARC team's research, 87% of patients using a kiosk would use it again to speed things along. In fact, the latest kiosk prototype actually plugs in and has a fully functioning touch screen. Based on that work, a top-level committee is weighing the addition of kiosks across the Rochester campus.
  Already, SPARC's reach is expanding. What began a couple of years ago as an intriguing but modest concept was named one of the Mayo Clinic's top priorities last year. SPARC's full-time staff has grown from two to six. There are a half-dozen projects going on, and the number of workshop participants is 500 and counting. SPARC is catching on, winning traction-and, hopefully, sparking Mayo's next whirl of innovation.
  
  LANGUAGE TIPS
  Kiosk 亭子
  Iteration 重说、重做
  Primitive 简单的
  Ventriloquist 腹语术者
  Tackle 处理、对付
  Acronym 首字母简略词
  Diagnosis 诊断
  Tacit 缄默的
  Endocrinologist 内分泌专家
  Cholesterol 胆固醇
  Reconvene 重新召集
  Anatomical 解剖学的
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